Magnesium sulfate reduces sevoflurane-induced emergence agitation in pediatric patients

Bondok, Rasha S; Ali, Rania M

doi:10.4103/1687-7934.139544

Cited by 11 publications

(24 citation statements)

References 2 publications

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“…A similar haemodynamic profile was recently reported with the use of magnesium sulphate for the management of status asthmaticus in paediatric patients [23]. Also, Bondok and Ali (2014) showed a significant stabilization in the heart rate and the systolic blood pressure during the removal of LMA and emergence in group M compared with group C [24]. In addition, there was a significant decrease in heart rate intraoperatively (T3) and postoperatively (T4) (P < 0.05) in the magnesium group when compared with the control group [7].…”

Section: Discussionsupporting

confidence: 80%

“…Also, the scores of agitation were higher in the control com-pared with the magnesium group with a significant difference at all assessment points in the PACU [22]. A recent studies proposed the same idea as magnesium sulphate caused a significant reduction in sevoflurane-induced EA with no delay in patient discharge [24,29]. The efficiency of magnesium in decreasing the postoperative pain and delirium could be attributed to its action as NMDA receptor antagonist [30][31][32].…”

Section: Discussionmentioning

confidence: 89%

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Effect of intravenous magnesium sulphate or dexamethasone as adjuvants to sevoflurane anesthesia to prevent delirium during primary cleft palate repair, controlled randomized blind study

Elsonbaty

lsonbaty

2017

Egyptian Journal of Anaesthesia

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Background: Emergence delirium (ED) is a frequent postoperative complication in young children undergoing cleft palate repair and it may be exacerbated by sevoflurane anesthesia. Objective: This study was undertaken to study the effect of magnesium sulphate or dexamethasone as adjuvants to sevoflurane in decreasing the delirium after primary cleft palate repair. Patients and methods: 90 patients undergoing primary cleft palate repair were randomized into 3 groups equally. Controlled group (group C): continue without any addition, Magnesium group (group M): 30 mg/kg loading dose on 10 min then 10 mg/kg every one hour though the operation and Dexamethasone group (group D): 0.15 mg/kg single dose after induction. During the study period, heart rate, mean arterial blood pressure, postoperative delirium, blood glucose level and nausea were recorded for 120 min. Results: The heart rate and blood pressure were significantly decreased in group M and group D, than the control group. Significant lower postoperative delirium and nausea in group D and M in comparison with control group although D group had the best effects. Conclusion: Co-administration of intravenous magnesium sulphate or dexamethasone with to sevoflurane anesthesia during primary cleft palate repair provides more vital hemodynamic state and decrease in postoperative vomiting and delirium when compared with control group.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 89%

Effect of intravenous magnesium sulphate or dexamethasone as adjuvants to sevoflurane anesthesia to prevent delirium during primary cleft palate repair, controlled randomized blind study

Elsonbaty

lsonbaty

2017

Egyptian Journal of Anaesthesia

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“…It seems to be related to emergence agitation and shivering, both of which are common during recovery from pediatric anesthesia (incidence up to 80%) . In most reviewed studies, IV MgSO 4 (20–30 mg·kg −1 ± 10 mg·kg −1 ·h −1 ) appeared to prevent and reduce the incidence and intensity of both phenomena, mainly in adenotonsillectomy surgery , while only one paper found no significant difference . Moreover, locoregional MgSO 4 also showed to decrease the incidence of agitation, both in peritonsillar infiltrations (2–5 mg·kg −1 ) and in caudal blockades (total dose of 50 mg) .…”

Section: Magnesium Sulfate In Pediatric Anesthesiamentioning

confidence: 99%

“…Sevoflurane has certain excitatory effects on the central nervous system, which may be associated with increased seizure activity in children. It seems to be related to emergence agitation and shivering, both of which are common during recovery from pediatric anesthesia (incidence up to 80%) (7,8). In most reviewed studies, IV MgSO 4 (20-30 mgÁkg À1 AE 10 mgÁkg À1 Áh À1 ) appeared to prevent and reduce the incidence and intensity of both phenomena, mainly in adenotonsillectomy surgery (7-10), while only one paper found no significant difference (11).…”

Section: Muscle Relaxationmentioning

confidence: 99%

Magnesium sulfate in pediatric anesthesia: the Super Adjuvant

Rebollar

Palacios

Guerrero

et al. 2017

Pediatric Anesthesia

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Magnesium is an essential chemical element in all organisms, intervening in most cellular enzymatic reactions; thus, its importance in homeostasis and as a therapeutic tool in highly challenging patients such as pediatrics. The primary purpose of this paper was to review the role of magnesium sulfate as an adjuvant drug in pediatric anesthesia. This compound already has the scientific backing in certain aspects such as analgesia or muscle relaxation, but only theoretical or empirical backing in others such as organ protection or inflammation, where it seems to be promising. The multitude of potential applications in pediatric anesthesia, its high safety, and low cost make magnesium sulfate could be considered a Super Adjuvant.

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“…Additionally, the use of magnesium during the perioperative period has been associated with increased sedation, analgesia, reduced administration of neuromuscular blockade agents, and the prevention of ischemic-reperfusion injury [4,5]. In children, intraoperative infusion of magnesium may reduce emergence agitation after adenotonsillectomy [6] and hernia repair [7]. However, Apan et al [8] reported that magnesium supplementation had no in uence on the incidence of emergence agitation in paediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Magnesium Supplementation and Postoperative Recovery Quality in Children Undergoing Strabismus Surgery: A Prospective, Randomised, Controlled Study

J¹,

Choi²,

M³

et al. 2020

Preprint

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Background: The benefits of intraoperative magnesium supplementation have been reported. In this prospective, randomized study, the effects of magnesium supplementation during general anesthesia on emergence agitation and postoperative pain in children were evaluated.Methods: A total of 66 children aged 2 to 5 years who underwent strabismus surgery were assigned to the magnesium or to the control group. Preoperative anxiety was assessed using the modified Yale Preoperative Anxiety Scale. After anesthesia induction, the magnesium group received an initial loading dose of 30 mg/kg magnesium sulphate over 10 min and, then, continuous infusion of 10 mg/kg per h until 10 min before the end of the surgery. The control group received an equal volume of normal saline via the same regimen. The Pediatric Anesthesia Emergence Delirium (PAED) score, pain score, and respiratory events were assessed at the postanesthetic care unit.Results: Data obtained from 65 children were analyzed. The PAED and pain scores of the two groups did not differ significantly. There were 26 of 33 (78.8%) and 27 of 32 (84.4%) children with emergence agitation in the control and the magnesium groups, respectively (odds ratio 0.69, 95% CI 0.19–2.44; p = 0.561). The preoperative anxiety score was not significantly correlated with the PAED score. The incidence of respiratory events during the emergence period did not differ significantly between the two groups. Conclusions: Magnesium supplementation during anesthesia had no significant effects on the incidence of emergence agitation or postoperative pain in children undergoing strabismus surgery.Clinical trial registry: ClinicalTrials.gov (NCT03132701)

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Magnesium sulfate reduces sevoflurane-induced emergence agitation in pediatric patients

Cited by 11 publications

References 2 publications

Effect of intravenous magnesium sulphate or dexamethasone as adjuvants to sevoflurane anesthesia to prevent delirium during primary cleft palate repair, controlled randomized blind study

Effect of intravenous magnesium sulphate or dexamethasone as adjuvants to sevoflurane anesthesia to prevent delirium during primary cleft palate repair, controlled randomized blind study

Magnesium sulfate in pediatric anesthesia: the Super Adjuvant

Magnesium Supplementation and Postoperative Recovery Quality in Children Undergoing Strabismus Surgery: A Prospective, Randomised, Controlled Study

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